• What causes gynecomastia?

Many factors can upset the balance of hormones and create the phenomenon of gynecomastia. The most common are the following:

• Idiopathic gynecomastia: this is the unspecified source of gynecomastia. The causes of breast swelling cannot be identified.
• Obesity: the massive growth of the breast is due to the high accumulation of body fat.
• Physiological gynecomastia: refers to the feminization of the breast due to a genetic abnormality, i.e. the predominance of female hormones, which can occur in any age group.
• Endocrinologic: concerns diseases such as hypogonadism, Klinefelter syndrome, pituitary insufficiency, etc.
• Neoplasm: This is the formation of a tumor in various parts of the body due to the abnormal growth of cells.
• Systemic diseases: related to the biological and chemical dysfunction of the body that affects its entirety, such as kidney failure, liver cirrhosis, etc.
• Substance abuse and alcohol

In any case, a detailed hematological – endocrine examination should be performed to avoid serious diseases.

• Who is it for?

Gynecomastia affects a large part of the male population. There is no age restriction but usually the phenomenon occurs during:

• the neonatal age through the placenta with the transfer of maternal estrogen to the newborn infant. Gynecomastia later subsides.
• adolescence due to the increased amount of estrogen present in the body shortly before the start of production of male hormones. Gynecomastia can subside.
• adulthood due to weakened testosterone levels. Gynecomastia is corrected only after surgery.

The operation can be performed as soon as the interested party is 18 years old, when the physical development is complete, and the hypertrophic breast growth remains.

• How is the diagnosis made?

If gynecomastia is suspected, it is necessary to visit a specialized doctor to examine the degree of gynecomastia and to have a first retrieval of the medical history. If the first examinations indicate the phenomenon of gynecomastia, then the candidate will undergo new examinations, breast ultrasound or mammography.

• Is gynecomastia surgery painful?

During the operation the patient does not feel any pain, only a slight one postoperatively. The pain is tolerable and manageable with the help of special analgesics that will relieve the patient and eliminate the discomfort.

• What complications may occur?

Some of the low-risk complications that can occur are hematoma, infection, nipple asymmetry, nipple tenderness and delayed recovery. However, with modern medical tools and the experience of the Plastic Surgeon those can be limited and dealt with.

• What kind of tests will be needed before the operation?

The person concerned will need to undergo a series of tests before the operation in order for the necessary data for the operation to be obtained and any risk of complication to be avoided. These are general blood tests, biochemistry blood tests, an electrocardiogram, and a chest x-ray, as well as a hormonal test (LH, FSH, thyroid hormones, testosterone and estrogen, prolactin).

• How long does the operation last?

The operation lasts 1-2 hours depending on the stage of the gynecomastia. Usually, local anesthesia is used in combination with sedation to remove the accumulated fat, while for the removal of the mammary gland, especially in the case where there is some association with breast cancer, general anesthesia is recommended.

• During surgery

The operation is performed painlessly by making a small inconspicuous incision in the lower part of the nipple (areola). In small degrees of gynecomastia, the mammary gland and the accumulated fat are removed, using mainly liposuction and, if necessary, in greater degrees, the excessive skin, so that the breast can be repositioned and set to its normal position.

• After surgery

The patient, after a local anesthesia, can leave the clinic after a few hours, however, after a general anesthesia, to spending the night for 24 hours and being discharged the next day is wiser. At first, there will be some edemas in the chest, maybe ecchymoses, and there will be a slight pain. Everything will gradually subside after about 10 days. For 1 month it is important for the patient to wear an elastic bandage – vest on the chest to recover quickly and to avoid any infections.

• In how many days can one return to their daily activities?

Already after 7 days the patient can return to work and daily activities, as long as he does not make an intense effort and wears the elastic bandage recommended by the Plastic Surgeon. After 1 month he will be able to participate in all his activities undisturbed.

• Results

The results are visible from the first 10 days after the edema subsides. The chest will look well-shaped and in complete harmony with the rest of the body. Full recovery will occur in just 1 month and the result will be permanent. As the body weight increases or decreases, the chest will fluctuate accordingly, and the body will remain symmetrical. Confidence will return and negative thoughts will disappear.